Dandruff is actually a common chronic scalp condition marked by flaking of the skin on your scalp. Dandruff is not contagious or serious. But it can be embarrassing and most times difficult to treat.
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The good news is that dandruff often can be controlled. Mild cases of dandruff may need nothing more than daily shampooing with a gentle cleanser. More-stubborn occurrence of dandruff often respond to medicated shampoos.
For most teens and adults, dandruff signs are easy to spot: white, oily-looking flakes of dead skin that dot your hair and shoulders, and a possibly itchy, scaly scalp. The condition may worsen during the fall and winter, when indoor heating can add to dry skin, and improve during the summer.
A type of dandruff known as cradle cap can affect babies. This disorder, which causes a scaly, crusty scalp, is most common in newborns, but it can happen anytime during infancy. Although it can be alarming for parents, cradle cap isn’t dangerous and usually clears up on its own.
Dandruff could have several causes, including:
- Irritated, oily skin (seborrheic dermatitis).This condition, one of the most frequent causes of dandruff, is characterized by red, greasy skin covered with flaky white or yellow scales. Seborrheic dermatitis may affect your scalp and other areas rich in oil glands, such as your eyebrows, the sides of your nose and the backs of your ears, your breastbone (sternum), your groin area, and sometimes your armpits.
- Not shampooing often enough.If you do not regularly wash your hair, oils and skin cells from your scalp can build up, causing dandruff.
- A yeastlike fungus (malassezia).Malassezia lives on the scalps of most adults. But, for some, it irritates the scalp and can make more skin cells to grow.
The extra skin cells die and fall off, making them look white and flaky in your hair or on your clothes. Why malassezia irritates some scalps is not known.
- Dry skin.Flakes from dry skin are generally smaller and less oily than those from other causes of dandruff. And, redness or inflammation is unlikely. You’ll probably have dry skin on other parts of the body, such as your legs and arms, too.
- Sensitivity to hair care products (contact dermatitis).Sometimes sensitivities to certain ingredients in hair care products or hair dyes can create a red, itchy, scaly scalp.
Almost anyone can have dandruff, but some factors can make you more susceptible:
- Dandruff usually starts in young adulthood and continues through middle age. That doesn’t mean older adults don’t get dandruff. For some people, the issue can be lifelong.
- Being male.Since more men have dandruff, some researchers think male hormones may play a role.
- Oily hair and scalp.Malassezia feeds on oils in your scalp. For that reason, having excessively oily skin and hair makes you more prone to dandruff.
- Certain illnesses.For reasons that are not clear, adults with neurological diseases, such as Parkinson’s disease, are more likely to have seborrheic dermatitis and dandruff. So are people with HIV infection, or those who have compromised immune systems from other conditions.
Often the doctor can diagnose the problem simply by looking at your hair and scalp.
Dandruff can almost always be controlled, but dandruff treatment may take some trial and error. In general, daily cleansing with a gentle shampoo to lower oiliness and skin cell buildup can often help mild dandruff.
When regular shampoos fail, dandruff shampoos you can purchase at a drugstore may succeed. But dandruff shampoos are not all alike, and you may need to experiment until you find one that works for you.
If you start itching, stinging, redness or burning from any product, stop using it. If you develop an allergic reaction — such as a rash, hives or difficulty breathing — look for immediate medical attention.
Dandruff shampoos are classified according to the medication they contain:
- Pyrithione zinc shampoos (such as Head & Shoulders, Jason Dandruff Relief 2 in 1).These contain the antibacterial and antifungal agent zinc pyrithione. This type of shampoo can lower the fungus on your scalp that can cause dandruff and seborrheic dermatitis.
- Tar-based shampoos (such as Neutrogena T/Gel).Coal tar, a byproduct of the coal manufacturing process, assist conditions such as dandruff, seborrheic dermatitis and psoriasis. It lowers how quickly skin cells on your scalp die and flake off. If you have light-colored hair, this type of shampoo may create discoloration.
- Shampoos containing salicylic acid (such as Neutrogena T/Sal).These “scalp scrubs” help eliminate scale, but they may leave your scalp dry, resulting in more flaking. Using a conditioner after shampooing can help relieve dryness.
- Selenium sulfide shampoos (such as Selsun Blue).These shampoos slow your skin cells from dying and may also reduce malassezia. Because they can discolor blond, gray or chemically colored hair, be sure to use them only as you directed, and rinse well after shampooing.
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- Ketoconazole shampoos (such as Nizoral).Ketoconazole is a broad-spectrum antifungal agent that may work when other shampoos fail. It’s offered over-the-counter as well as by prescription.
Try using one of these shampoos daily or every other day until your dandruff is controlled; then cut back to two or three times a week, as required. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two types of dandruff shampoos.
Read and follow the directions on each bottle of shampoo you try. Some have to be left on for a few minutes, while others should be immediately rinsed off.
If you’ve shampooed faithfully for several weeks and there’s still a dusting of dandruff on your shoulders, talk to your doctor or dermatologist. You may need a prescription-strength shampoo or treatment with a steroid lotion.